Comparison of Prevalent Hypertension by Aortic versus Brachial Blood Pressure Criteria for - A Pulse Wave Analysis Based Study from Adults of a City of West India.

Background: Disparities exist in aortic blood pressure (aBP) and brachial blood pressure (bBP) and between aortic (AH) versus brachial hypertension (BH). While the former is superior, it is studied scarcely. Pulse wave analysis (PWA) provides objective and simultaneous measurement of both blood pressures to determine AH and BH. Using PWA, we compared prevalent AH and BH in a sample adult population.

Methodology: By oscillometric PWA (Mobilograph, IEM, Stolberg, Germany), 1187 participants with age >18 years were evaluated. Simultaneous aBP and bBP were recorded by standard PWA protocol and prevalence of AH and BH was estimated. Age and gender-based subgroups were compared for aortic versus brachial BP differences. Prevalence of Hypertension, Isolated Systolic Hypertension, and Pulse Pressure ≥40 was compared between aortic versus brachial criteria.

Results: Significant differences were seen between bBP and aBP across all age groups and in both genders, especially for the younger age groups. As compared to bBP, aBP gave a higher fetch for prevalent hypertension and a lower fetch for prevalent Isolated Systolic Hypertension (ISH). bPP ≥40 was sensitive but not specific as a surrogate for aPP ≥ 40.

Conclusion: Across ages 18-65 in either sex, disparities exist between bBP and aBP mostly for SBP and PP with significant differences in prevalent Hypertension, Isolated Systemic Hypertension, and high pulse pressure. It reaffirms disparities of aBP and bBP and diagnosed brachial or central hypertension based on them with the need for further work.